predictive values of programmed death-1, cc chemokine ligand 20, and treg/t helper 17 cytokines for patients with hepatitis b virus-related acute-on-chronic liver failure

Background: this study aimed to explore the correlations of programmed death-1 (pd-1) and cc chemokine ligand 20 (ccl20) with treg/t helper 17 (th17) balance in patients with hbv-aclf. methods: in this cross-sectional study, 50 patients with hbv-aclf and 50 cases with chronic hepatitis b (chb) diagnosed from february 2021 to february 2022 were selected, and another 50 healthy volunteers who received physical examinations in the same period were selected as a control group. the expression levels of pd-1, ccl20, and treg/th17 cytokines were detected by western blotting, immunoturbidimetry, and enzyme-linked immunosorbent assay (elisa), respectively. the correlations of pd-1 and ccl20 with treg/th17 cytokines were explored by pearson analysis. the predictive values of pd-1, ccl20, and treg/th17 cytokines for the prognosis of hbv-aclf patients were analyzed. results: the expression levels of pd-1 and ccl20 were higher in the hbv-aclf group than in the chb and control groups (p < 0.05). severe hbv-aclf patients had higher levels of pd-1 and ccl20 compared with mild and moderate hbv-aclf patients (p < 0.05). hepatitis b virus-related acute-on-chronic liver failure patients with poor prognosis had higher levels of pd-1 and ccl20 than those with good prognosis (p < 0.05). the levels of transforming growth factor β (tgf-β), interleukin 10 (il-10), il-23, and tumor necrosis factor α (tnf-α) were higher in the hbv-aclf group than in the chb and control groups (p < 0.05). the levels of pd-1 and ccl20 in the hbv-aclf group were positively correlated with those of treg/th17 cytokines (tgf-β, il-10, il-23, and tnf-α; p < 0.05). the combined detection of pd-1, ccl20, and treg/th17 cytokines had higher sensitivity and lower specificity than single detection in predicting the prognosis of hbv-aclf patients (p < 0.05). conclusions: the expression levels of pd-1 and ccl20 are higher in hbv-aclf patients, being correlated with treg/th17 balance. the combined detection of pd-1, ccl20, and treg/th17 cytokines has a higher value for predicting the prognosis of hbv-aclf patients.